Transcript for audio podcast: October 2014 OIG Monthly Update
From the Office of Inspector General of Department of Health and Human Services
Welcome to one of a continuing series of podcasts highlighting the work of the Office of Inspector General.
This is Mike Kane, inviting you to follow us on our website (oig.hhs.gov) and on Twitter (@OIGatHHS).
The OIG FY 2015 Work Plan is on our website now - don't miss it! https://oig.hhs.gov/reports-and-publications/workplan/index.asp#current
Nursing home chain Extendicare agreed to pay $38 million dollars in a quality-of-care settlement with OIG. As part of the settlement, the company agreed to correct alleged serious lapses that affect seniors.
Since our last podcast, OIG has issued a number of reviews.
OIG found that the Food and Drug Administration should address cyber vulnerabilities on its network that could lead to a data breach.
Texas improperly claimed an estimated $30.3 million dollars for nonemergency medical transportation services in FY 2011, OIG found in a second review.
OIG noted in one report that Massachusetts received about $106 million dollars more than it should have because of incorrect Medicaid claim adjustments, and OIG recommended that the state refund the money to the federal government.
In another report, OIG recommended strengthened oversight of state standards for access to care in Medicaid managed care programs.
In a fifth review, OIG noted that New York claimed an estimated $23 million dollars in Medicaid reimbursement for unallowable supported employment services.
Shire Pharmaceuticals in Wayne, Pa., is to pay $56.5 million dollars to resolve civil allegations that it improperly marketed and promoted several drugs.
Drugmaker Organon is to pay $31 million dollars to settle allegations of false claims to state Medicaid programs. Authorities say Organon underpaid rebates, offered improper incentives and illegally promoted its antidepressants.
A Houston hospital president, his son and two others were convicted in a $158 million dollar scam that included sham mental health services, kickbacks, false claims and money laundering. Ten defendants have now been convicted in the fraud scheme.
An Akron doctor admitted illegally prescribing hundreds of thousands of painkillers and other pills for no legitimate medical purpose. The physician continued to illegally prescribe pills, even after some of his customers suffered overdose-related deaths. Steven M. Dettelbach, U.S. attorney for the Northern District of Ohio, said the doctor "is simply a drug dealer who happened to wear a white coat and worked from a medical office instead of a street corner. His actions destroyed lives and families."
A Florida doctor and two others were charged in a $55 million dollar mental health clinic scheme that involved alleged false billing and ineligible patients.
Three Floridians were charged in a $23 million dollar Medicare scam; drug trafficking, kickbacks, bogus prescriptions and money laundering are alleged.
Also in Florida, a home health care company administrator was jailed for nearly 6 years in a $6 million dollar Medicare false billing scam; full restitution was ordered. The administrator paid kickbacks to patient recruiters and falsified patient documentation. Six other defendants were charged in another case involving the same company.
A Florida home health agency and its owners are to pay $1.65 million dollars to resolve false claims allegations. The agency allegedly paid spouses of referring doctors for sham jobs that required little or no work. The salaries allegedly served as an inducement and reward for the physicians' referrals of Medicare patients.
Seven were charged and three others entered guilty pleas in a $56 million dollar home health and durable medical equipment scheme in Louisiana.
OIG Most Wanted fugitive Felix Gonzalez, charged in a $32 million dollar Medicare scheme, was captured in Miami.
Dr. Uche Chukwudi, indicted in a $7.3 million dollar medical equipment scheme in California, has been added to OIG's Most Wanted Fugitives list.
OIG and the Centers for Medicare & Medicaid Services jointly issued an interim final rule extending waivers associated with the Shared Savings Program.
And OIG has proposed a rule to amend its safe harbors to the anti-kickback statute and civil monetary penalty rules.
A number of HHS-OIG staff -- individuals and team members - were recognized by their peers for their outstanding accomplishments over the last year. The awards were presented during the 17th annual inspector general community awards ceremony, sponsored by the Council of the Inspectors General on Integrity and Efficiency.
For links to these reports and stories and more, go to our website or follow us on Twitter.
And for more on the fight against health care fraud, waste and abuse, click "More News" on the podcast webpage.
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